DeanCare Gold Enhanced (Cost)
Available to residents of Grant County, WI for 2027. Contract H5264, plan 002, segment 0.
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- Benefits in plain text
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2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
New for 2027. This plan has no 2026 predecessor in the CMS crosswalk. Every WI plan’s 2026–2027 changes →
Plan details
| Monthly premium (Part C + D) | $199.00 |
|---|---|
| — medical (Part C) part | $199.00 |
| — drug (Part D) part | —? |
| Health plan deductible (in-network) | None |
| In-network out-of-pocket maximum | $5,900.00? |
| Drug deductible | this plan has no drug coverage |
| Plan type | Cost? |
| Contract / plan | H5264-002-0 |
| Offered by | Dean Health Plan, Inc. |
| Parent organization | Medica Holding Company |
| Member services | (888)422-3326TTY 711 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- 3.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- —
Published per contract — every plan under contract H5264 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | $0 copay |
| Other health care professional | $0 copay |
| Preventive care | |
| Medicare-covered preventive services | $0 copay |
| Annual physical exam | $0 copay |
| Kidney disease education | $0 copay |
| Glaucoma screening | $0 copay |
| Diabetes self-management training | $0 copay |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | $0 copay |
| Lab services | $0 copay |
| Diagnostic radiology (e.g. MRI, CT) | $0 copay |
| Therapeutic radiology | $0 copay |
| Outpatient x-rays | $0 copay |
| Emergency and urgent care | |
| Emergency room | $0 copay |
| Urgent care | $0 copay |
| Worldwide emergency coverage | 20% coinsurance after a $250 deductible · $50,000 plan limit |
| Worldwide urgent care | 20% coinsurance after a $250 deductible · $50,000 plan limit |
| Worldwide emergency transportation | Not covered |
| Hospital care | |
| Inpatient hospital stay | $0 per stay |
| Outpatient hospital services | $0 copay |
| Outpatient observation | $0 copay |
| Ambulatory surgical center | $0 copay |
| Outpatient blood services | $0 copay |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per stay |
| Home health care | $0 copay |
| Kidney dialysis | $0 copay |
| Rehabilitation | |
| Occupational therapy | $0 copay |
| Physical therapy and speech-language therapy | $0 copay |
| Cardiac rehabilitation | $0 copay |
| Pulmonary rehabilitation | $0 copay |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | $0 per stay |
| Outpatient mental health, individual session | $0 copay |
| Outpatient mental health, group session | $0 copay |
| Psychiatrist, individual session | $0 copay |
| Psychiatrist, group session | $0 copay |
| Partial hospitalization | $0 copay |
| Intensive outpatient program | $0 copay |
| Outpatient substance use, individual session | $0 copay |
| Outpatient substance use, group session | $0 copay |
| Opioid treatment program | $0 copay |
| Ambulance and transportation | |
| Ground ambulance | $0 copay |
| Air ambulance | $0 copay |
| Transportation to plan-approved locations | $0 copay |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | $0 copay |
| Prosthetics (e.g. braces, artificial limbs) | $0 copay |
| Medical supplies | $0 copay |
| Diabetes supplies | $0 copay |
| Diabetic therapeutic shoes or inserts | $0 copay |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | $0 copay |
| Routine chiropractic care | $0 copay |
| Acupuncture | Not covered |
| Foot exams and treatment (Medicare-covered) | $0 copay |
| Routine foot care | Not covered |
| Dental? | |
| Medicare-covered dental services | $0 copay |
| Oral exams | $0 copay(limits apply) |
| Cleanings | $0 copay(limits apply) |
| Fluoride treatment | Not covered |
| Dental x-rays | $0 copay(limits apply) |
| Other diagnostic dental services | Not covered |
| Other preventive dental services | $0 copay(limits apply) |
| Restorative services (fillings, crowns) | Not covered |
| Endodontics (root canals) | Not covered |
| Periodontics (gum disease) | Not covered |
| Dentures and other removable prosthodontics | Not covered |
| Maxillofacial prosthetics | Not covered |
| Implants | Not covered |
| Bridges and other fixed prosthodontics | Not covered |
| Oral and maxillofacial surgery | Not covered |
| Orthodontics | Not covered |
| Adjunctive general services | Not covered |
| Vision? | |
| Eye exam (Medicare-covered) | $0 copay |
| Routine eye exam | $0 copay(limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | $0 copay(limits apply) |
| Eyewear plan limit | $125 plan limit every year |
| Contact lenses | $0 copay(limits apply) |
| Eyeglasses (frames and lenses) | $0 copay(limits apply) |
| Eyeglass lenses | $0 copay(limits apply) |
| Eyeglass frames | $0 copay(limits apply) |
| Eyewear upgrades | $0 copay(limits apply) |
| Hearing? | |
| Hearing exam (Medicare-covered) | $0 copay |
| Routine hearing exam | $0 copay(limits apply) |
| Hearing aid fitting and evaluation | $0 copay(limits apply) |
| Hearing aid plan limit | $150 plan limit every year |
| Hearing aids (all types) | $0 copay(limits apply) |
| Hearing aids, inner ear | Not covered |
| Hearing aids, outer ear | Not covered |
| Hearing aids, over the ear | Not covered |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | Not covered |
| Meals after a hospital stay or for a chronic condition | $0 copay |
| Fitness benefit | Not covered |
| Health education | Not covered |
| Nutritional / dietary benefit | Not covered |
| Extra smoking and tobacco cessation counseling | $0 copay |
| Enhanced disease management | Not covered |
| Telemonitoring | Not covered |
| Remote access technologies (web/phone, nurse line) | $0 copay |
| Home and bathroom safety devices | Not covered |
| Counseling services | Not covered |
| In-home safety assessment | Not covered |
| Personal emergency response system (PERS) | Not covered |
| Medical nutrition therapy | Not covered |
| Post-discharge in-home medication reconciliation | Not covered |
| Re-admission prevention | Not covered |
| Wigs for hair loss from chemotherapy | Not covered |
| Weight management programs | Not covered |
| Alternative therapies | Not covered |
| Therapeutic massage | Not covered |
| Adult day health services | Not covered |
| Home-based palliative care | Not covered |
| In-home support services | $0 copay |
| Support for caregivers | Not covered |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2027). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Staying Healthy: Screenings, Tests and Vaccines | ||
| Breast Cancer Screening · C01 | 4 out of 5 stars for Breast Cancer Screening | 4 out of 5 stars for Breast Cancer Screening |
| Colorectal Cancer Screening · C02 | 5 out of 5 stars for Colorectal Cancer Screening | 5 out of 5 stars for Colorectal Cancer Screening |
| Annual Flu Vaccine · C03 | 5 out of 5 stars for Annual Flu Vaccine | 5 out of 5 stars for Annual Flu Vaccine |
| Improving or Maintaining Physical Health · C04 | 2 out of 5 stars for Improving or Maintaining Physical Health | 2 out of 5 stars for Improving or Maintaining Physical Health |
| Improving or Maintaining Mental Health · C05 | 2 out of 5 stars for Improving or Maintaining Mental Health | 2 out of 5 stars for Improving or Maintaining Mental Health |
| Monitoring Physical Activity · C06 | 2 out of 5 stars for Monitoring Physical Activity | 3 out of 5 stars for Monitoring Physical Activity |
| Managing Chronic (Long Term) Conditions | ||
| Diabetes Care – Eye Exam · C11 | 4 out of 5 stars for Diabetes Care – Eye Exam | 4 out of 5 stars for Diabetes Care – Eye Exam |
| Diabetes Care – Blood Sugar Controlled · C12 | 5 out of 5 stars for Diabetes Care – Blood Sugar Controlled | 5 out of 5 stars for Diabetes Care – Blood Sugar Controlled |
| Kidney Health Evaluation for Patients with Diabetes · C13 | 3 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes | 4 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes |
| Controlling High Blood Pressure · C14 | 3 out of 5 stars for Controlling High Blood Pressure | 4 out of 5 stars for Controlling High Blood Pressure |
| Reducing the Risk of Falling · C15 | 2 out of 5 stars for Reducing the Risk of Falling | 3 out of 5 stars for Reducing the Risk of Falling |
| Improving Bladder Control · C16 | 3 out of 5 stars for Improving Bladder Control | 2 out of 5 stars for Improving Bladder Control |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions · C20 | 2 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions |
| Member Experience with Health Plan | ||
| Getting Needed Care · C21 | 3 out of 5 stars for Getting Needed Care | 4 out of 5 stars for Getting Needed Care |
| Getting Appointments and Care Quickly · C22 | 5 out of 5 stars for Getting Appointments and Care Quickly | 3 out of 5 stars for Getting Appointments and Care Quickly |
| Customer Service · C23 | 3 out of 5 stars for Customer Service | 5 out of 5 stars for Customer Service |
| Rating of Health Care Quality · C24 | 5 out of 5 stars for Rating of Health Care Quality | 5 out of 5 stars for Rating of Health Care Quality |
| Rating of Health Plan · C25 | 5 out of 5 stars for Rating of Health Plan | 5 out of 5 stars for Rating of Health Plan |
| Care Coordination · C26 | 4 out of 5 stars for Care Coordination | 5 out of 5 stars for Care Coordination |
| Member Complaints and Changes in the Health Plan's Performance | ||
| Complaints about the Health Plan · C27 | 5 out of 5 stars for Complaints about the Health Plan | 5 out of 5 stars for Complaints about the Health Plan |
| Members Choosing to Leave the Plan · C28 | 5 out of 5 stars for Members Choosing to Leave the Plan | 5 out of 5 stars for Members Choosing to Leave the Plan |
| Health Plan Quality Improvement · C29 | 3 out of 5 stars for Health Plan Quality Improvement | 3 out of 5 stars for Health Plan Quality Improvement |
| Health Plan Customer Service | ||
| Plan Makes Timely Decisions about Appeals · C30 | 5 out of 5 stars for Plan Makes Timely Decisions about Appeals | 4 out of 5 stars for Plan Makes Timely Decisions about Appeals |
| Reviewing Appeals Decisions · C31 | 2 out of 5 stars for Reviewing Appeals Decisions | 4 out of 5 stars for Reviewing Appeals Decisions |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H5264 shares it.
Also available in 7 other WI counties
Benefits in plain text
DeanCare Gold Enhanced (Cost) (H5264-002-0) is a 2027 Cost Medicare Advantage health plan without drug coverage offered by Dean Health Plan, Inc., available to residents of Grant County, WI.
The monthly premium is $199.00.
There is no in-network deductible for health services.
Its in-network out-of-pocket maximum is $5,900.00.
Email a copy of the plan benefit details
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.